Provider Demographics
NPI:1053915272
Name:GAINES, MOLLY VICTORIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:VICTORIA
Last Name:GAINES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 GOLDEN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-6924
Mailing Address - Country:US
Mailing Address - Phone:256-832-0046
Mailing Address - Fax:256-832-0335
Practice Address - Street 1:1404 GOLDEN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-6924
Practice Address - Country:US
Practice Address - Phone:256-832-0046
Practice Address - Fax:256-832-0335
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist